An abdominal aortic aneurysm (AAA) is a bulge or swelling in the wall of the aorta, the body’s largest blood vessel, as it passes through the abdomen. If left untreated, an AAA can rupture, causing life-threatening bleeding.

Causes

AAA develops when the wall of the aorta weakens. Factors contributing to its development include:

1. Atherosclerosis: Plaque buildup weakens the aortic wall.
2. Genetic Factors: Family history increases the risk.
3. High Blood Pressure: Exerts additional stress on the aorta.
4. Smoking: A significant risk factor for aneurysm formation.
5. Age & Gender: More common in men over 65 years of age.

Symptoms

Most AAAs develop gradually and remain asymptomatic until they enlarge or rupture. Symptoms, when present, may include:

• Pulsating Feeling: In the abdomen, similar to a heartbeat.
• Abdominal Pain: Persistent or sudden and severe.
• Back Pain: Radiating to the legs or groin.
• Rupture Symptoms: Sudden, intense pain, dizziness, rapid heart rate, or loss of consciousness, which require immediate medical attention.

Diagnosis

• Ultrasound: The most common method to detect AAAs.
• CT Scan or MRI: Provides detailed images and helps assess size and risk.
• Physical Exam: Occasionally, a large AAA can be felt during an exam.

Treatment

Treatment depends on the size and risk of rupture:

1. Small AAAs (<5.5 cm):
   • Regular monitoring through imaging.
   • Lifestyle changes such as quitting smoking and managing blood pressure.
2. Large AAAs (≥5.5 cm) or Symptomatic:
   • Open Surgical Repair: Removal of the aneurysm and replacement with a graft.
   • Endovascular Aneurysm Repair (EVAR): A minimally invasive procedure using a stent graft.

Prevention

• Quit Smoking: Reduces the risk of aneurysm development and rupture.
• Control Blood Pressure & Cholesterol: Prevents further weakening of the aortic wall.
• Healthy Lifestyle: A balanced diet and regular exercise.
• Regular Screening: Recommended for men over 65 who have ever smoked or have a family history of AAA.